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The Basics of Knee Arthroscopy in Los Angeles

What is Knee arthroscopy?

Knee arthroscopy is a kind of keyhole surgery carried out on inside of your knee joint to both diagnose and treat damage inside the joint. You might elect to undergo the procedure if you have a torn meniscus, torn ACL and other conditions.

Knee Specialist Los Angeles

Arthroscopy is used to analyze several knee problems, such as, torn meniscus (kneecap), or repair ligaments in joint. Knee problems are accompanied by severe pain which patients must be aware of. Your recuperation time and visualization will rely upon the seriousness of the knee problem and the unpredictability of how long it may last.

Why Prefer Knee arthroscopy?

The following are the major reasons why knee arthroscopy is recommended:

  • Torn meniscus. Meniscus is defined as a ligament that pads the space found between the bones in the knee. It can be repaired through Surgery.
  • Damaged anterior cruciate ligament (ACL)
  • Swollen or injured covering of the joint. This coating is known as the synovium.
  • Misalignment of the kneecap.
  • Small pieces of damaged ligament up the knee joint
  • Removal of Baker’s lump. The swelling takes place at the knee where liquid has been filled. Now and then the issue happens if swelling and pain exist for different reasons, similar to joint inflammation
  • A few fractures of the knee bones.

How is a Knee Arthroscopy Performed?

Knee arthroscopy is generally performed under broad sedative, though it can be done under spinal anesthesia, or analgesic. During this procedure, antibacterial liquid is used to clean the skin on the affected joint. A small entry point, a couple of millimeters long, is made so that the arthroscope can be inserted. One or more extra cuts will also be made so that an examining test can be done and other fine surgical instruments can be inserted. The Los Angeles orthopedic doctor will fill the joint with a clean liquid to extend it and make it easier for viewing. Doing so will help the doctor see the inside of your joint using a fiberoptic camera. This allows the orthopedic physician to repair existing damage or also shave if indicated.

The Los Angeles knee doctor will further carry out more tests using arthroscope and, if necessary, remove or repair any areas affected with the help of surgical instruments embedded through the entry points. After the procedure, the arthroscope and any other instruments are removed, alongside any excess liquid from the joint.

How does a Knee arthroscopy Relieve Pain?

The doctor recommends that you take your pain management medication at the onset of pain. This will help relieve pain before it becomes acute. You may also prefer to have a nerve block, which is a pain reliever after surgery. Ensure you take the recommended medication to help relieve pain in the nerve.

Are there Risks Associated with Knee arthroscopy?

While knee arthroscopy is highly recommended for treatment of knee injuries, there are a few dangers that patients ought to be aware of. Upon undergoing the knee arthroscopy, patients may experience incidences such as swelling, infection, bleeding, drainage, blood clots to name the key ones. All these should be reported to the doctor so that you can get the best advice on what to do.

Dr. Raj at Beverly Hills Orthopedic Institute is the top knee specialist in Los Angeles and Beverly Hills. Most insurance is accepted, call (310) 247-0466 today!

Knee Cartilage Restoration Procedures in Beverly Hills & LA

A cartilage restoration procedure is something used to repair damage cartilage in the knee. Before you undergo cartilage restoration you will first have to meet with Los Angeles orthopedic surgeon who will diagnose the initial injury. The work up will include an MRI which is used to determine the severity of the injury as well as the location of the injury and the size of the injury. Knee pain

All of this is important because it has a direct impact on the type of surgical procedure used to rectify the problem. You will also have to undergo some regular bloodwork and a general check up with your primary care physician prior to your procedure with an orthopedic surgeon.

These processes will be used just to make sure that there are no underlying health concerns which could prevent you from having the procedure you need.

There are several types of cartilage restoration procedures available, depending on the extent of the damage. The possibilities are:

1. OATS Procedure – transplanting healthy cartilage to a fixed area with damaged cartilage using osteoarticular transfer surgery (OATS) .

2. ACI – autologous chondrocyte implantation – a process where healthy cartilage cells are taken from the knee, cultured in the lab for several weeks, and then new cells form.

3. Microfracture procedure – the involves small drillings into the knee cartilage to produce bleedKnee Specialist Los Angelesing to produce bone marrow, stem cells and growth factors.

Your orthopedic surgeon will discuss any potential complications with you prior to the procedure. The is always a possibility for infection, bleeding, nerve injury, anesthesia complication and that the procedure may not work.


The recovery time following such procedures is really contingent upon the severity of your individual case. You will be able to discuss the details of this with your orthopedic surgeon after the surgery. The amount of time that you must complete physical therapy and the type of physical therapy must complete is really contingent upon the severity of your case and what orthopedic surgeon prescribes. The pain and discomfort you feel will last for an average of 2 to 3 weeks following your surgery but it will take several weeks beyond this to fully recover.

The top knee specialist in LA and Beverly Hills is Dr. Raj at Beverly Hills Orthopedic Institute. Call (310) 247-0466 for more information and scheduling with the orthopedic surgeon Beverly Hills trusts!

Finding the Best Orthopedic Surgeon in Beverly Hills & Los Angeles

If you have sustained a severe injury to one of your joints your doctor will more than likely recommend that you meet with an orthopedic surgeon. An orthopedic surgeon is somebody who specializes in surgical (and nonsurgical) procedures of the bones, joints, tendons and ligaments. They are the most qualified person to help you rectify any joint problems you may be experiencing. But finding the best Los Angeles and Beverly Hills orthopedic surgeon can be difficult.Knee Specialist Los Angeles

Meeting for a Consultation

Before you allow an orthopedic surgeon to operate on you, it is important that you are comfortable with them.  This consultation is generally reserved to address your current situation as well as assess your qualifications for a surgical procedure.

But during this time you should also meet with them to see how you feel. If you initially are put off by something perhaps as innocuous as a personality conflict you should trust your instincts and look for somebody else. The orthopedic surgeon that you end up working with should be somebody you trust entirely. This is just one of the strong points of Dr. Raj at Beverly Hills Orthopedic Institute. His bedside manner is comforting and compassionate.

Surgeon Qualifications

It’s important to check the credentials of your orthopedic doctor such as Board Certifications. Dr. Raj, for instance, is Board Certified in three countries and has been named the top orthopedic doctor in Los Angeles for several years in a row.

He is an ABC News Medical Correspondent and a WebMD Expert.

total-knee-replacement2-193x300Insurance Qualifications

Of course you also want to make sure that the orthopedic surgeon you work with is somebody covered by whatever healthcare insurance plan you have. You can check this by asking your health care insurance providers for a list of orthopedic surgeons in Los Angeles who are covered under your plan. Out of Network coverage may be fine as well.

Surgical Statistics

If you are concerned about the complications associated with your surgical procedure it is imperative that you work with an orthopedic surgeon who has extended expertise and has been working successfully for many years. You may just want to ask the doctor if the procedure under consideration is something the surgeon performs on a regular basis.


Dr. Raj at Beverly Hills Orthopedic Institute is the top orthopedic doctor in Southern California, and has extensive experience in hip and knee replacement, along with minimally invasive arthroscopic procedures. Call (310) 247-0466 today!

ACL Reconstruction Basics Treatment By Knee Specialist Los Angeles

ACL Reconstruction Basics

ACL reconstruction is a surgical process which is used to rebuild the ligaments located around your knee. This ligament can give way during physical activity and cause a tear. In this area you have three bones that form the joint Bethany and on top of these three bones the kneecap protects this joint. Oliver bones are protected with ligaments in the same area. In your knee you have four main ligaments which hold your bones in place much like a rope. Is the ligaments in your knee is injured it is called a sprain. There are three levels of sprains the first of which is mild. With a mild sprain the ligament is stretched but it can still hold your knee joint where it needs to. Normal sprain, grade 2, is one which stretches your ligament after which the ligament itself remains loose. This care is considered a partial tear. The most severe care is when your entire ligament tears into two separate pieces and leaves your joint unstable.

What are the causes of this?

ACL Tear2If you are playing sports and you stop suddenly you can cause the ligament to care. If you are changing your direction instantly or you slow down while you are running you can cause a tear in your ligament. Landing incorrectly from a jump can also cause a tear in your ligament. Female athletes have a higher rate of torn ligaments compared to male counterparts. The reason for this is a different size and shape of the pelvis and different muscular strength.

What are the symptoms of a torn ligament?

If you hear a popping noise in your knee after one of the causes listed above and your knee instantly swells within 24 hours it may be indicative of a torn ligament and it may require surgery. If you find that walking brings you discomfort and you have a complete loss of motion in your knee it may also be indicative of your need for surgery.

What is the surgical treatment like?

anterior-cruciate-ligament-acl-reconstruction-graft-selection-osuv6n2-3-2coljpgRepairing the ligament in your knee can be done through physical therapy and nonsurgical bracing. If these preliminary methods are insufficient to meet your needs you may have to seek surgical rebuilding by a knee specialist Los Angeles for your ligament. In this case the torn ligament is stitched back together in order to restore stability. There are some cases where the tear is so severe that your orthopedic surgeon in Los Angeles has to replace the torn ligaments using a graft. A graft functions like scaffolding and it holds your knee in place until new ligament grows.

What is the procedure like?

ACL repairIf you use surgical options to repair you’re torn ligament it is often done by an orthopedic surgeon in Los Angeles using an arthroscopy. With an arthroscope a small incision is made in your knee and a tube is inserted through that incision which contains a small camera on the end. This is known as a minimally invasive procedure and the benefits of using such a procedure include leaving you in less pain during and after the procedure and providing you with a faster recovery time.

To learn more about ACL reconstruction, contact knee specialist, Dr. Raj in Los Angeles today.

Cartilage Restoration Procedures with a Top Los Angeles Orthopedic Surgeon

Cartilage Restoration Procedures

If you have knee pain, you may suffer from damaged cartilage. The cartilage around your knee is a rubbery material which covers the end of your bones. This cartilage helps to absorb shock and reduce friction in your joint. As the cartilage deteriorates or becomes damaged it can limit your movement and cause you severe pain in your knee. If you do not treat damaged cartilage you can worsen the condition and eventually required knee replacement knee cartilagetherapy.

Who qualifies for cartilage restoration procedures?

Cartilage restoration procedures are a treatment for knees that are otherwise healthy, not affected by arthritis, but are still deteriorating. The treatment is typically recommended for patients who have damage to their knee cartilage caused by a sports injury, trauma, congenital abnormality, or mono disorder, or repetitive use of the joint.

What happens during the procedure?

Before your doctor agrees to go through with cartilage restoration procedures, you will have an MRI to determine how severe the injury to your cartilage is and the location and size of the damage. Many of the knee procedures performed are done with an arthroscope, which is a popular modern surgical tool/procedure used to limit the pain and recovery time for surgery.

This is a surgical tool and process which is minimally invasive and often recommended for most knees surgeries this process requires an initial incision which is quite small in your meet. After the first incision is made a long and thin tube will be placed inside the cut, this too has a camera at the end which is connected to the videoscreen inside of the operating room. The surgeon can then get a better view inside of your knee joint through this camera and knee cartilage defectdetermine where the afflicted cartilage is located and the severity of the afflicted cartilage.

Many times you can have the affected area rectified during this procedure. If the doctor finds the affected cartilage, they can make a secondary incision through which the microscopic surgical tools are inserted and the cartilage is repaired and restored. Due to the small incisions and the minimally invasive nature of this procedure, recovery time is faster than a standard surgical procedure. In addition, the surgical process itself takes an average of two hours. It is typically performed as an outpatient procedure which means you do not have to spend the night in the hospital.

What happens after the procedure?

After the procedure it is recommended that you have somebody take you home and stay with you for the first night. Within one week you should be able to dress yourself and within 4 to 6 weeks you should be completely healed. Your Los Angeles orthopedic surgeon will talk to you about any potential complications and a rehabilitation process which you will design together. Depending on the severity of your surgical procedure, you may need to complete your physical therapy under the supervision of a licensed physical therapist. This is imperative for you to regain the motion and flexibility of your knee.

Dr. Raj is the top Beverly Hills and Los Angeles orthopedic surgeon, and is an expert in cartilage restoration procedures. Most insurance is accepted, simply call (310) 247-0466 today!





The Amazing Knee – Info from the Top Beverly Hills Orthopedic Surgeon

The Amazing Knee

The knee joint is one of the most amazing joints in the body; it is also the most abused.  The knee is subjected to a great deal of stress and weight every time you put your foot on the ground. The more you weigh and the more vigorous your activity, the more stress you place on the joint. Understanding how the knee works can help you protect it from injury.Orthopedic Surgeon Beverly Hills

The knee joint is composed of four bones:

  • the thigh bone (femur)
  • shin bone (tibia)
  • smaller shin bone (fibula)
  • knee cap (patella)

These four bones are connected by muscles, ligaments, and tendons, and together these structures allow you to move and keep your knee joint stable, aligned, and healthy.

Another integral part of the knee structure is cartilage. This gel-like, elastic tissue is a security and shock-absorber system rolled into one: it prevents the ends of the knee bones from banging and grinding against each other whenever your knee moves, and it absorbs the shock that impacts your knee every time you walk, run, jog, squat, climb stairs, or even stand.

If you are an athlete, you may be familiar with the term torn cartilage. This refers to damage to a layer of thick cartilage called the meniscus. The meniscus cushions the meeting point of the tibia and femur and absorbs the impact from movement while also helping to stabilize the knee joint. The knee joint also contains articular cartilage, a smooth tissue that covers the underside of the patella and lines the area of the femur so these bones can move effortlessly whenever you bend and straighten your knee.

Because of the stress put on this large joint, knee pain and injuries are common. The most common knee problems include:

  • ArthritisKnee Injury Pain
  • Ligament injuries
  • Cartilage injuries
  • Tendonitis
  • Fractures
  • Dislocations

Each case is unique, but treatments for these conditions range from ice and rest to physical therapy, or in some cases surgery is required.

If you are experiencing knee pain or problems, schedule a consultation with Dr. Raj. He can help you get back to doing the things you love.

Read more about the knee online at: http://www.nlm.nih.gov/medlineplus/kneeinjuriesanddisorders.html

March 24th, 2015|Dr Raj Best Knee Surgeon Los Angeles & Beverly Hills | Knee Surgery|Comments Off on The Amazing Knee – Info from the Top Beverly Hills Orthopedic Surgeon

High Tibial Osteotomy Procedure for Knee Arthritis

High Tibial Osteotomy

If you have arthritis in your knee, your surgeon may suggest a high tibial osteotomy procedure. This surgery is done to realign the angle at the knee joint between the tibia and femur, which is called an osteotomy.

xraynorm-arthritisThe advantage of this procedure is that it preserves the natural knee joint as opposed to replacing the structure with a prosthesis (device made of metal and plastic). This surgery is used for active, young patients who develop osteoarthritis of the knee that only affects one joint compartment.

Knee Anatomy and Arthritis

Knee arthritis occurs when there is loss of cartilage of the knee. The knee joint has three bones: the femur (thigh bone), the tibia (shin bone), and the patella (kneecap). These three bones form knee compartments. The femur meets the tibia to form the joint, and the patella lies at the front of the patella. These three bones are covered with cartilage, which is a white polished material that allows for smooth gliding of the bones.

When osteoarthritis occurs, the knee joint is stiff and painful. Basically, bone rides against bone. The Beverly Hills orthopedic surgeon corrects this by realigning the angle made between the bones of the leg, so the patient can shift his or her body weight, allowing the healthy side to assume the majority of stress. Realigning the knee joint angle between the tibia and femur is called an osteotomy.

Benefits of High Tibial Osteotomy

F1.largeThe high tibial osteotomy is helpful for patients with underlying pain and loss of range of motion from arthritis that affects one compartment of the knee. Once the load is decreased on the affected side of the knee, there is a delay in the need for a total joint replacement procedure. By reducing the heavy load, the pain and stiffness is also alleviated. In order to be a candidate for a high tibial osteotomy, you must have:

  • Some ligament function around the knee
  • Minimal arthritis in other compartments of the knee
  • An adequate range of motion

If your orthopedic surgeon thinks you are a suitable candidate for this surgery, a high tibial osteotomy will reduce pain and improve overall knee function. The chance of the procedure offering pain relief five years following the procedure is around 80 percent. That percentage drops to 70 percent after 10 years and down to 50 percent after 15 years.

Before the Procedure

a08fig03Prior to undergoing a high tibial osteotomy, you will have x-rays and an MRI of the knee to assess and gage the degree of arthritis and structure damage. The x-rays show the doctor how the compartment is functioning, so he or she can predict where you are carrying the majority of your weight and how to properly realign the leg to achieve the best outcome. The MRI assesses the cartilage throughout all regions of the knee joint, as well as the knee ligaments and meniscus.

You are admitted to the hospital the day of surgery, and an anesthesiologist or anesthetist will discuss available options for anesthesia with you. You also are given prophylactic antibiotics to decreased risk of infection. When you are in the operating room, the anesthesia is given, and the surgical staff prepares your knee for the operation.

Two Methods of High Tibial Osteotomy

Closing wedge osteotomy – This procedure involves removing a piece of bone below the joint of the upper tibia. When arthritis has affected the medial knee compartment (as with varus knees), the bone wedge is taken from the outer region of the tibia. Once the bone segment is removed, the two bone ends are fixed together using a metal plate and pins.

Opening wedge osteotomy – In the wedge procedure, the orthopedic specialist cuts through the tibia on the inner side to open a wedge. This is often done by adding a segment of bone graft from the pelvic bone to hold the region open. The stabilize this, the surgeon inserts a plate and pins. This knee surgeryoperation is most often done to the upper aspect of the tibia, right below the knee joint.

During the Procedure

During the high tibial osteotomy procedure, care is taken by the Los Angeles orthopedic surgeon to protect the blood vessels and nerves that are behind and around the knee joint. A small part of the fibula bone is used to in the closing wedge osteotomy, which is performed through the same incision.

Usually, a drain is inserted to allow the surgical wound to drain, and it will remain there for 24 hours. The incisions are closed and the leg is wrapped in a dry, sterile dressing. Many times, a brace will be required for a short time following the surgery.

After the Procedure

The patient is transported to a recovery room, where he or she is closely monitored following the high tibial osteotomy. An x-ray is taken of the knee to assess for alignment.

Once stable, the patient is taken to a hospital room and a physical therapist provides passive range of motion exercises. The day after surgery, you are taught to use crutches for up to three months. Most patients are able to go home three days after the procedure. Therapy continues once you are released to home, to help you improve mobility and regain muscular strength of the knee joint.

During the first week after the procedure, your leg will be swollen and the knee will feel stiff. Most orthopedic specialists prescribe regular pain medication during this time frame. It is vital for you to perform the exercises while at home to optimize recovery and rehabilitation. It may take up to six months to full recover from a high tibial osteotomy. Therefore, the most important aspect of rehabilitation is to strengthen the knee and allow it to heal.

Success Rate of a High Tibial Osteotomy

Around 70 percent of patients who have a high tibial osteotomy are satisfied with the results, and around 75 percent are able to return to sports and/or work activities. When the procedure fails, the orthopedic surgeon may suggest a total knee replacement. However, most patients who undergo this procedure have functioning knees at five to ten years following the surgery.

Risks of a High Tibial Osteotomy

All surgeries carry some risks and complications. The high tibial osteotomy is a safe procedure, but complications include:

  • Bleeding
  • InfectionBest Los Angeles Orthopedic Surgeons
  • Blood clots of the legs
  • Knee stiffness
  • Damage to surrounding blood vessels and/or nerves
  • Failure of the cut bone to heal
  • Discomfort from metal-ware and subsequent removal
  • Unexpected fractures
November 24th, 2014|Dr Raj Best Knee Surgeon Los Angeles & Beverly Hills | Knee Surgery|Comments Off on High Tibial Osteotomy Procedure for Knee Arthritis

Overview of Allograft Hamstring ACL

Primary ACL reconstruction is a commonly performed orthopedic surgery in the United States. There are approximately 100,000 procedures performed each year in America. It is estimated that the acute rupture incidence in the general population is around one in 3,000. This condition appears to be increasing in the female athletic participants. One form of reconstruction is the allograft hamstring ACL repair.ACL Tear2

Hamstring allograft tissue comes from a cadaver, whereas an autograft comes from the patient’s own tissue. Using an allograft is beneficial, as it avoids the risk of harvest site morbidity. There is less loss of motion and less surgical time with an allograft as compared to an autograft. However, allografts do have some disadvantages, such as availability, cost, immune response, delayed graft healing, and infection risk.

Hamstring tendons are an effective graft choice for allograft ACL reconstruction. ACL allograft constructs provide equally stable components at three year follow-up when compared to other tissue grafts. For many patients, the immune response and bacterial infection risk is diminished with the modern allograft processing technique and shorter surgical time. This is likely due to the smaller incision that is required with the allograft tissue, which reduces bacterial infection risk.

Allograft Processing

anterior-cruciate-ligament-acl-reconstruction-graft-selection-osuv6n2-3-2coljpgModern allograft processing procedures have greatly improved allograft safety. Now, with nucleic acid testing for contagious viruses, there is a reduction in processing time from 22 to 12 days.

Tissue processing provides a delicate balance between preserving the biologic function of the tissue and the removal of the potentially infectious agents. Also, processing often involves terminal sterilization and/or chemical disinfectants. This reduces the risk of cross-contamination and terminal contamination.

Autograft vs. Autograft

An autograft has certain disadvantages, such as harvest-site morbidity, dependence of donor tissue integrity, and increased surgical time. Also, patients who have this procedure experience postoperative neuroma, patellar injuries, scarring, and poor repair. Additionally, when the patient’s own hamstring is used, there is a 15 percent of knee flexor strength reduction, which can affect athletes who sprint or do squatting maneuvers.

There are many advantages of allograft tissue, such as reduced operative time and improved healing of the knee. Some research suggests that there is less rehabilitation time with an allograft, as well as a reduction of stiffness and postoperative pain. In the studies that compare autografts to allografts in primary ACL reconstruction, there is consistent equivalent clinical efficacy.

Before Surgery

Once you are at the hospital, you will be changed into a hospital gown and an intravenous (IV) line is placed in the hand or arm. This is used to deliver anesthesia medications and fluids during and after the procedure. Most patients receive general anesthesia, and the surgeon will have you sign a consent form also.

The Procedure

Once in the operating suite, you are given anesthesia and monitored with brain and heart wave electrode devices. Once you are under the effects of the anesthesia, the skin is prepped with a surgical scrub and draped. The graft is prepared by trimming and cleaning tissue so the ends can be sutured. Three small incisions are made around the knee, and sterile fluid is pumped into the joint.ACL repair

A small camera is introduced into the knee joint, and any repairs are made to the ACL stump. Once the graft is placed, it is secured with a metal button, screw, or other device. After graft placement and stability is checked, the instruments are removed and a sterile dressing is applied along with a cold pack and compression wrap.


You will be brought to the recovery unit and monitored after the ACL hamstring allograft surgery. A physical staff will go over home care and instructions with you and the person driving you home. Once home, a physical therapist will meet with you to teach home exercises and crutch use. This procedure is done on an outpatient basis, so expect to be at the hospital from six to eight hours.

October 20th, 2014|Dr Raj Best Knee Surgeon Los Angeles & Beverly Hills | Knee Surgery|Comments Off on Overview of Allograft Hamstring ACL

FAQs on Knee Replacement Treatment

What condition requires knee replacement?

The knee is one of the primary load-bearing joints of the body. Aside from supporting the weight of the body, the knee also absorbs the impact from movement, such as walking, running, and jumping. The knee is a hinge joint that connects the femur, tibia, fibula and the patella. Articular cartilage covers the ends of the tibia and femur, as well as the posterior of the patella. This articular cartilage allows the bony surfaces of the knee to glide along each other, allowing smooth movement of the joint. Aside from this, the knee also has two rubbery, C-shaped pads known as the medial meniscus and lateral meniscus. These provide shock absorption for the knee.knee replacement

As the body ages, the articular cartilage and menisci are worn down. This happens because of the progressive wear and tear of daily use, as well as the normal physiologic process of aging. Cartilage that was once elastic stiffens, further aggravating the damage to the knee. The articular cartilage that protects the knee can be worn down, causing pain and inflammation of the affected joint. This condition is known as osteoarthritis. Osteoarthritis is a disease that appears with aging, and is associated with risk factors like obesity.

Aside from degenerative conditions like osteoarthitis, acute trauma to the knee can damage the structures of the knee to the point where it is beyond repair. Considerations must also be made to the age of the patient, and the potential gains for their quality of life.


How is the knee replaced?

The replacement of a joint is known as arthroplasty. During knee replacement, the entire knee is usually removed: the ends of the tibia, fibula and femur are removed, as well as the patella. The ends of the tibia, fibula and femur are then reshaped by the surgeon to fit the replacement knee. The damaged knee is replaced by an artificial knee implant that is made of non-absorbable material such as polyethelene and metal.

total knee replacementThe implant is then placed and secured in position with screws and surgical glue. The artificial knee implants glide together, replicating the movement of the knee. After the knee implant is in place, the surgeon tests the range of motion of the knee before closing the incision and ending the operation. There have been numerous advances to the field of arthroplastic surgery. New techniques have been developed to allow as much sparing of the bone as possible, and bone-sparing techniques have made partial knee replacement possible.

The knee is immobilized for some time after the procedure to allow healing of the joint. It is recommended that patients who undergo knee replacement surgery should undergo a program of physical therapy and rehabilitation. This will strengthen the stabilizing muscles of the knee, and train the patient how to ambulate with his new prosthetic knee.


What are the outcomes of knee replacement?

Knee replacement is normally tolerated by most patients. Patients are normally able to ambulate soon after the procedure, and most report improvements in their quality of life after the procedure. There are still risks to surgery, however, such as persistent postoperative pain or stiffness, or infection of the surgical site.



July 16th, 2014|Dr Raj Best Knee Surgeon Los Angeles & Beverly Hills | Knee Surgery|Comments Off on FAQs on Knee Replacement Treatment

FAQs on ACL Reconstruction Treatment

How does ACL injury occur?

Tears of the anterior cruciate ligament (ACL) are one of the most common injuries to the knee. In the United States of America alone, it is estimated that there are over 200,000 cases of ACL injury.ACL Tear2

The anterior cruciate ligament is one of the four ligaments that stabilize the hinge joint of the knee. The ACL, in particular, runs diagonally in the middle of the knee. Its primary purpose is to prevent the tibia from sliding out in front of the femur. Due to its configuration, the ACL also provides rotational stability to the knee.

ACL injury occurs when an external stress causes damage to the knee beyond what the ACL can bear, causing the ligament to tear. It is estimated that around 70 percent of ACL injuries are from non-contact mechanisms; i.e., from landing awkwardly, or from falls, and other similar accidents. Direct damage from external trauma has also been known to cause ACL tears. Athletes in high-risk sports are at greater risk for ACL injury.


Why is ACL reconstruction done?

Not all cases of ACL injury are eligible for surgery. The treatment option for ACL injury is conservative, when possible. This may involve rest and rehabilitation. Surgery is considered when the tear is complete, or when the damage to the ligaments is severe.

ACL reconstruction seeks to restore patency to the damaged ligament. The development of this procedure has been of great significance to athletes: prior to advances in ACL reconstruction, tears to the ACL were considered a career-ending injury, from which there was no complete recovery.


What is the procedure for ACL reconstruction?ACL repair

The term ACL reconstruction is actually a misnomer. The ACL is not “rebuilt”, since a torn ACL cannot be sewn back together to restore its patency. ACL reconstruction refers to the surgical replacement of the damaged ligament with a tendon that is either harvested from the patient’s own body, or from a cadaver.

Autografts refer to surgical grafts that are taken from the patient, while allografts are harvested from cadavers. The patellar tendon is most commonly used for autografts, although they may also be harvested from other parts, such as the hamstring tendons. Allografts, on the other hand, are taken from cadavers. These are associated with a higher risk of graft rejection.

After the procedure, the knee is typically immobilized to allow recover. The knee will have to undergo a gradual and progressive program of physical therapy and rehabilitation to restore normal function of the joint. Recovery from surgery can take up to a year after the procedure, and there is a risk of persistent postoperative pain and stiffness.

ACL reconstruction provides the definitive treatment of tears and injury to the ACL. It is considered the best option for complete tears of the ACL. The gold standard of ACL repair is reconstruction using patellar autografts. However, it should be noted that there are still risks with the procedure. Graft rejection remains a possibility, especially for allograft replacements. There can also be intraoperative damage to the surrounding tissues. ACL reconstruction is generally well tolerated, however, and most patients report favorable outcomes.


July 12th, 2014|Dr Raj Best Knee Surgeon Los Angeles & Beverly Hills | Knee Surgery|Comments Off on FAQs on ACL Reconstruction Treatment